This Company Wants to be the Apple Store for Depressed People

This Company Wants to be the Apple Store for Depressed People,

New startups like to describe themselves using the ones that succeeded before them (see: Uber for weed, Tinder for gamers, Airbnb for dogs, etc). In its demo last week at IndieBio, biotech startup accelerator NeuroQore announced that it aims to be the “Apple Store for depression.”

Looking to disrupt depression and its associated therapies, NeuroQore approaches the condition as a functional problem, a gridlock in the brain’s electrical circuits to be overcome with controlled magnetic pulses. The Ontario-based health tech company has raised more than $2 million in funding, and has units in three medical centers in Canada, with three California locations planned for 2017.

The technology at the center of NeuroQore is a brain-zapping technique called repetitive transcranial magnetic stimulation (rTMS). In rTMS, focused magnetic pulses are applied to the brain to induce currents, activating neurons to restore normal brain activity. While rTMS is not a new technology, NeuroQore’s mission is to create an improved rTMS system that leads to higher remission rates, which is a common measure for success in treatments for depression.

Delivered in outpatient settings, NeuroQore would allow people with depression to go to one of their clinics or partner with health providers to get a treatment. A typical rTMS session lasts around 20 minutes and costs a few hundred dollars per session, which is administered by a technician or nurse.

Zapping the brain as therapy goes way back (remember One Flew Over the Cuckoo’s Nest?). Electroconvulsive Therapy (ECT) is supervised by a physician, requires anesthesia, and is quite costly—roughly $2,500 per session. This approach is often used for treating depression when traditional medical treatment doesn’t work. ECT still has a bit of an image issue, as the concept conjures up crudely electrifying the brain with high-voltage bolts. The reality is much more controlled, but is still invasive, as it requires hospitalization and can cause patients to have seizures.

Nonetheless, ECT is more effective than rTMS, which CEO Mehran Talabinejad himself notes in his presentation. A 2014 meta-analysis in the journal Depression Treatment and Research, compared ECT and rTMS concludes just this. The analysis neither dismisses or fully endorses the validity of TMS, but “indicates an important role for rTMS in the management of treatment-resistant depression, especially in select patient groups.” In other words, this is a potentially useful option for people whose depression isn’t responding to the usual therapy-plus-meds approach.

In NeuroQore’s favor, rTMS has already been approved as a valid form of treatment by the FDA. And about that Apple store idea: Talabinejad mentions NeuroQore is building their own clinics, where patients have their own dedicated concierge , perhaps analogous to the Apple Geniuses. Whether NeuroQore can achieve this vision is questionable. Their plans for growth seem unrealistic: With three centers in Canada, NeuroQore aims to have over 100 centers across the US in the next three years. To create this type of demand, NeuroQore will have to prove their technology has improved rTMS efficacy, while also convincing more doctors and patients to use it. Currently, Talabinejad is planning to partner with large medical groups that provide patients while NeuroQore provides training, equipment, and “maintaining service excellence.”

Commoditizing rTMS, NeuroQore’s stated goal, has the tangible public benefit of providing effective alternative depression treatments. If NeuroQore attracts people who would avoid ECT, (and thereby forgo treatment for depression) it could have a net positive impact. But if, on the other hand, people with treatment-resistant depression opt to use NeuroQore instead of more effective treatments like ECT, it’s of questionable benefit, especially considering that depression can sometimes be a matter of life and death.

The NeuroQore pilot is still underway; the results show that it can improve the remission rate of rTMS technology, there is a clear market for the business.
The 2014 Depression Treatment and Research meta-study notes that rTMS is “largely contingent upon further technological as well as logistical advances that can help to clarify effective use, cost-effectiveness, access to treatment, and patient selection.” If NeuroQore can address these contingencies, we will see more of rTMS, and NeuroQore, in the future.

Images: IndieBio Demo Day Video

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Ashwin Rodrigues


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